For surgeons, suturing was long the standard in tissue fastening and repair. But, with the advent of laparoscopic surgery, surgeons were removed from the immediacy of contact with the surgical site that aided suturing. One of the complicating aspects of laparoscopic suturing is tying a knot in the laparoscopic environment. The current techniques are complicated, take many hours to master, and are easily forgotten. As a result, many surgeons avoid laparoscopic suturing, preferring instead to either use alternate tissue fastening methods (clips, staples, endo-loops or loop-sutures), or to avoid those laparoscopic procedures which could require suturing.